Pierre Lemelin, Ph.D.

Forearm and Hand

ANAT 403–The Human Body

I. Skeleton

a) Distal Humerus
Anytime youlook at muscles in the forearm
flexormuscles allattach on medialepicondyle
• medial epicondyle
• lateral epicondyle
• trochlea ventral Cantenordivisions ofbrachialplexus
• capitulum extensormuscles all attach on lateralepicondyle
• olecranon fosssa elevator dorsal posterior divisions of brachialplexus
• coronoid fossa
radial nerve

e
ulnafitsduringextension
uq
yygy.ie tititygom I
coronoid
pagingf
polst Tonlyfoundonanterioraspectof
elbowCooint surface

ii
b) Radius
ant andint
ultra 4 pwnat.on supination
• head joint nun go.in
•
•
neck
radial tuberosity
slightlyconcae an
Ma
B
radiusupland
holds
ligament
• styloid process

In
syndesmosis
c) Ulna attachmentfor

• olecranon process
• trochlear notch
• coronoid process

E
ix
• radial notch
• styloid process una
La
bone
lift
that
joint
synovial
carpal

upnation
1 for pols
 ulna is always onlittlefingerside
postaxialside
d) Carpal bones radiusis always onthumbs.de
preax.at side
• scaphoid (3) lunate
• lunate (4)
• triquetrum (5) triquetumetriqueta
• pisiform (6)
Éoooodomo

X
• trapezium (7)
• trapezoid (8)
• capitate (9)
Iid same
M
• hamate (10)
cradianofproximal oustarts
lateral L
paginate

e) Metacarpals and Phalanges m

softhemarticulate w carpals thanbase
• base
• shaft
• head

proximal and
2Phalangesforthum distal
3 Phalangesfor fngs 11 W proximal middleanddistal
Ratemetacarpal phalanges

II. Joints

a) Elbow joint

• humeroradial joint (capitulum of humerus

and radial head): pronation/supination of
forearm and hand L M

with
• humeroulnar joint (trochlea of humerus and
trochlear notch of ulna): flexion/extension of
the forearm

formsring
aroundradial
ma
Calma ulna
prevents dislocation of radiusfrom
capitulum

2
b) Radioulnar joints

• proximal radioulnar joint (anular

ligament)
• distal radioulnar joint (triangular
fibrocartilage or disc) r
* articulation of some carpal bones with the
triangular disk (not the ulna) e
consular
steroidprocess

c) Wrist joint
Ra
•
intr
radiocarpal joint & intercarpal
a
(midcarpal) joints: flexion/extension scaphoid lanate

7
and abduction/adduction of the hand
radius andscaphoidlunate midcarpalooint
a proximal distal
rowotcarpay

d) Carpometacarpal (CM) joint

• CM joint of thumb (saddle-

shaped): opposition of the thumb
(compound movement involving
abduction, flexion, and medial metacarpal I
rotation at the CM-I joint)

opposition abduction awayfromPam adduction and

medial rotation saddlejoint

e) Metacarpophalangeal (MP) joints gym

f
• designed for flexion/extension of
the digits, abduction/adduction,
and some rotation of the fingers
findshapes
(digits II – V)

f) Interphalangeal (IP) joints

• proximal (PIP) and distal (DIP) m me

mo
interphalangeal joints: p
flexion/extension of the
phalanges I
fusionand
extension

andaddiction
abduction
onlyoneinthethumb Uponflexion innternatomiddle
abductionislimitedforstrength singer
3
 III. Muscles and Innervation

a) Anterior compartment of forearm (= depressor muscles)

• superficial, middle, and deep layers

• flexion of the wrist and digits; abduction/adduction of the wrist; pronation of

forearm and hand

• All depressor muscles of forearm innervated by median nerve, EXCEPT flexor

carpi ulnaris and medial half of flexor digitorum profundus mm. which are
supplied by the ulnar nerve.

* Brachioradialis m. acts as a depressor muscle (flexion), but is derived from the

posterior compartment (innervated by radial n.).

arm forearm median n

it
median

gg p x
muscles
x

flexordigitorum
superficial's furor digitorum
profundum

Superficial layer Middle layer Deep layer

1: Brachioradialis m.* attaches onlateral

2: Pronator teres m. epicondyle compartment exception
poster
3: Flexor carpi radialis m. radial nine
4: Palmaris longus m. assistsinflexion offorearmat
elbow
5: Flexor carpi ulnaris m.
4
 b) Posterior compartment of forearm (= elevator muscles)

• superficial and deep groups

• extension of the wrist and digits; abduction/adduction of the wrist; supination of

forearm and hand

• all elevator muscles of forearm innervated by radial nerve (deep branch of radial
nerve).

X x X x
x x
All radial hem
inposteriorcompartment

1. Brachioradialis m. 6. Supinator m.
2. Extensor carpi radialis longus 7. Abductor pollicis longus m.
& brevis mm. 8. Extensor pollicis longus m.
3. Extensor carpi ulnaris m. 9. Extensor pollicis brevis m.
4. Extensor digitorum m 10. Extensor indicis m.
5. Extensor digiti minimi m.

5
 terminaltendon

I I DIP

PIP is
attaches
to ban
middle of
phalanx

___ Éent
FDP
attachesatdistalphalanx
mis
crosses PipandDip
Facesatmiddlephalanx
c) Intrinsic muscles of hand crossesmeandPip

• thenar group (opposition of the thumb): innervated by a branch of median n.

• hypothenar group: innervated by ulnar n. thenarnerve
• lumbricals: innervated by median n. & ulnar n.
• adductor pollicis muscle: innervated by ulnar nerve
• interossei muscles (dorsal and palmar): innervated by ulnar nerve

lambricals xx not athenar

muscle
lateral
ideoffingers
apdgg.EE

IE

f
I
hypothenau
me
pollicis IF
removethenar
eminence
eminence Deep aspect
Superficial aspect
mtiiÉ samifacias
pollicis 6
a and
 TIFFT FDP
amor'd
notproprioceptivenews
stretch
muscle

decreasestensiononflexorside increases extension tension

palmar
interossei

I p

l for index

iii
2 for middle

hasthe
abductor
minimi
digit

7
IV. Arterial supply to forearm and hand

• radial artery
• ulnar artery
• interosseous arteries (deep layers of forearm)

•
A
superficial palmar arch (primarily from ulnar artery)
byanastomoses
formed
• deep palmar arch (primarily from radial artery)
• digital branches

id
8